In a closely watched case, Massachusetts’ highest court recently decided that in certain limited circumstances, colleges and universities have a duty to protect students from self-harm, possibly giving rise to tort liability for the institution. Although the case currently only applies to Massachusetts institutions, it would not be surprising if other states follow Massachusetts’ lead and begin to scrutinize institutional responses more closely when students are at a risk of self-harm.

Nguyen v. Massachusetts Institute of Technology (MIT) involved the 2009 suicide of a 25 year-old graduate student. Nguyen had a lengthy history of mental illness, including two suicide attempts before coming to MIT, and he received care from numerous off-campus mental health professionals while he was enrolled. He also received various interventions from MIT faculty and staff, as well, particularly as test-taking problems and other academic challenges came to light. For example, an assistant dean in the student support office met with him multiple times, and worked to connect Nguyen both with MIT’s on-campus mental health resources as well as to coordinate with his off-campus providers. Ultimately, Nguyen rebuffed his efforts, repeatedly emphasizing that he wished to keep his mental health issues separate from his academic challenges.

The faculty within his program were unaware of the specifics of his mental health challenges, but they knew he was obtaining unspecified treatment off-campus. They worked to address his poor academic performance and the social challenges he had interacting with faculty in his discipline. In the summer of 2009, Nguyen sent a senior researcher an inappropriate and aggressive email, which resulted in the department head intervening and reading him “the riot act.” Immediately after this telephone call, Nguyen jumped to his death.

Nguyen’s father sued MIT, claiming that the suicide was foreseeable and that MIT did not do enough to prevent it. On appeal, the Supreme Judicial Court of Massachusetts began by examining what exactly MIT’s duty should have been to a student in Nguyen’s circumstances. The court concluded that in certain limited circumstances, the special relationship between a college and a student creates a duty to take reasonable measures to prevent suicide. Specifically, the court held that, “where a university has actual knowledge of a student’s suicide attempt that occurred while enrolled at the university or recently before matriculation, or of a student’s stated plans or intentions to commit suicide, the university has a duty to take reasonable measures . . . to protect the student from self-harm.” 1 The court went on to describe what “reasonable measures” might look like, including invoking a suicide protocol, or, in the absence of a protocol, contacting the appropriate individuals at the institution (such as in a Dean of Students’ office) to initiate and coordinate appropriate clinical care.2 In cases where a student refuses care, the court recommended that an institution notify a student’s emergency contact (such as their parents), or in crisis situations, emergency services personnel.

Then, applying this new rule, the court went on to decide in MIT’s favor, determining that under the specific facts presented in this case, MIT did not have a duty to protect this student from self-harm under these specific facts. Although Nguyen had previously attempted suicide, the prior attempts occurred more than one year before he arrived at MIT. Nguyen had never communicated by words or actions to any MIT employee that he had stated plans or intentions to commit suicide. Additionally, the court noted that Nguyen was a 25 year-old graduate student who lived off-campus, and he repeatedly rebuffed MIT’s supportive overtures, making clear that he wanted to keep his mental health issues separate from his academic issues. 3

Rethinking your Campus’ Response? Lessons for Institutions

The new rule established in this case arguably broadens the duty owed to college students, despite the court’s apparent efforts to specify the obligation placed upon colleges and universities. Until it is clear whether courts in other states will apply this same standard, institutions might consider some of the following steps:

What are your campus’s suicide prevention protocols? The Nguyen decision suggests that courts should defer to any suicide prevention protocols adopted by the institution to determine whether an institution has met its duty of care. Suicide protocols can address safety issues and planning, intervention in crisis situations, and emergency contact notification practices.

How are you training your campus stakeholders? The Nguyen decision suggests that numerous institutional employees have a duty to notify key points of contact (such as in your Dean of Students’ office) if they have knowledge that a student is at risk for self-harm. Much like reporting obligations in Title IX, this duty gives rise to training and education needs for a broad cross-section of staff and faculty members who interact regularly with students, including student residential life staff members. Who should they contact on campus if they have information that a student may be at risk for self-harm? What signs should they be looking for? How should they handle students’ demands for confidentiality? How should other students report concerns about peers?

Are your on-campus mental health professionals available to provide services in a timely manner? The court suggests that the duty for non-clinical staff is satisfied by escalating the situation to someone trained and capable to address it, such as an on- or off-campus mental health professional. Campus counseling centers, of course, are in high demand everywhere. Ensure, therefore, that when a non-clinician brings forward a concern that a clinician can be available to consult and triage in a timely way.

Are your campus’s recordkeeping practices in good shape? In Nguyen, the court looked carefully at records and correspondence about what various MIT faculty and administrators knew about the student’s mental health issues, and what they did in response. Be sure to keep accurate records of all communications and efforts to provide interventions and support, including outreach to off-campus health providers and emergency contacts.

Drummond Woodsum will continue to watch closely for any new developments, and especially if other states’ courts begin to apply Massachusetts’ new standard to similar cases. We are available to guide you in assessing best practices for addressing student self-harm; revising or creating protocols and processes; and developing training programs for campus stakeholders. If you have questions or would like to discuss the services we offer, please contact Jeanne Kincaid, Allen Kropp, Kim Pacelli or any member of our Higher Education Practice group.